A 24 year old man with an anterior lateral cystic neck mass is most apt to have a
A. Thyroglossal duct cyst
B. Brachial cleft cyst
C. Pleomorphic adenoma
D. Warthin tumor
Answer
Granulomas are characteristic of all EXCEPT:
A. Tuberculosis
B. Hypersensitivy pneumonitis
C. Histoplasmosis
D. Sarcoidosis
E. Asbestosis
Answer
A 67 year old man with a slowly worsening shortness of breath and a recent episode of hemoptysis. A non-smoker, he had been a deep coal miner for years. The chest radiographs show bilateral irregular areas of density in the upper lung lobes. An open lung biopsy reveals dense fibrosis and anthracosis in these areas; no malignancy is found. No necrosis is seen and no microorganism's are found. Your diagnosis:
A. Idiopathic interstitial fibrosis
B. Coal miner's pneumoconiosis with progressive massive fibrosis
C. Asbestosis
D. Silicosis
Answer
Pulmonary hypertension is LEAST likely in:
A. Patient with history of pulmonary emboli being treated for cancer by chemotherapy
B. Chronic bronchitis
C. Rheumatiod arthritis
D. Primary tuberculosis
Answer
The most likely cause of a pulmonary embolism:
A. Sudden death
B. Chronic cor pulmonale
C. Pulmonary infarction
D. Transient shortness of breath
E. No symptoms at all
Answer
The most common source of pulmonary emboli:
A. Hypogastric veins
B. Superior vena cava
C. Deep veins of the thigh
D. Axillary veins
E. Jugular veins
Answer
Patients with panacinar (panlobular) emphysema
A. Have diffuse interstitial lung fibrosis
B. May have related portal hypertension
C. Characteristically show mucus gland hyperplasia with an increase in the Reid index
D. Have medial hypertrophy of pulmonary arterial vessels by age 25
E. Have characteristic intra nuclear inclusions in pneumocytes
Answer
A 70 year old man presents slightly short of breath and afebrile. Multiple 1-2 cm nodules are found in the upper lobes of both lungs and mildly enlarged hilar lymph nodes are noted. Unfortunately, he is run down right outside your office by ( you guessed it) the Graham Service before you could talk to him further. The autpsy shows densely hyalinized fibrous with birefringent crystals and mild to moderate fibrosis which is most severe in the upper lobes of his lungs. No giant cells are seen and there is no necrosis. You guess that he retired from:
A. Pigeon breeding
B. Professional duck plucking
C. Quartz mining
D. Berrylium mining
E. Cotton farming
Answer
The most common cause of bacterial pneumonia
A. Pneumocystic carinii
B. Staphlococcus pneumonia
C. Escherichia coli
D. Streptococcus pneumonia
E. Pseudomonas aeroginosa
Answer
Dr. Slurpy, tired old pathologist, inhales his left lower bridge consisting of two teeth and completely obstructs his right lower lobe main bronchus. Wise but stubborn, he refuses surgical intervention for 2 weeks. By that time a right lower lobotomy is necessary. The LEAST likely pathological finding in light of the history:
A. Atelectasis
B. Emphysema
C. Empyema
D. Bronchiectasis
E. Broncopneumonia
Answer
A 45 year old man develops severe shortness of breath after an automobile accident. He is thought to have adult respiratory distress syndrome. The histological finding most characteristic of the first hours of the lesion:
A. Mucus plugs
B. Hemosiderin laden macrophages
C. Abscesses
D. Hyaline membranes
E. Multinucleated giant cells
Answer
The LEAST likely cause of adult respiratory distress syndrome:
A. Smoke inhalation
B. Right lower lobe mycoplasma pneumonia
C. Hemorrhagic shock
D. Disseminated intravascular coagulation
Answer
Mucus plugs are common findings in all EXCEPT:
A. Chronic bronchitis
B. Asthma
C. Panlobular emphysema
D. Cystic fibrosis
Answer
Pleuritis would be most likely in:
A. Lobar pneumonia
B. Early bronchopneumonia
C. Viral pneumonitis
D. Idiopathic pulmonary fibrosis
E. Sarcoidosis
Answer
The disease most likely to present as a solitary pulmonary nodule:
A. Asthma
B. Panacinar emphysema
C. Tuberculosis
D. Hypersensitivity pneumonitis
E. Asbestosis
Answer
Grey hepatization describes:
A. Liver cell metaplasia in interstial pneumonia
B. What happens to livers after the age of 100
C. A classic stage in lobular pneumonia with edema, red cell and neutrophil predominance in the intra-alveolar infiltrate
D. A classic stage in lobar pneumonia with fibrin predominance in the intra-alveolar infiltrate
Answer
The angiomatiod or plexiform lesion of pulmonary hypertension is most likely to occur in:
A. A 60 year old man with chronic bronchitis
B. A 35 year old male with Wegener's necrotizing granulomatosis and vasculitis
C. A 50 year old female non-smoker with an adenocarcinoma of the lung
D. A 5 year old with congenital cyanotic heart disease
E. A 70 year old person with end stage emphysema
Answer
The disease least likely to produce atelectasis:
A. Squamous cell carcinoma
B. Chronic bronchitis
C. Cystic fibrosis
D. Mycoplasma interstitial pneumonitis
Answer
The patient most likely to develop a pulmonary infraction after a pulmonary embolus:
A. A 25 year old athlete on crutches after a tibial fracture
B. A 65 year old chronic smoker hospitalized in traction after a motor vehicle accident with multiple pelvic fractures
C. A 10 month old boy hospitalized with RSV pneumonitis
D. A 32 year old ascribed health nut hospitalized for one week with pancreatis secondary to a common bile duct stone.
Answer
The major differences between bronchopneumonia and lobar pneumonia:
A. Kind of cells in the inflammatory infiltrate
B. Number of cells in inflammatory infiltrate
C. Degree of fibrovascular granulation tissue repair
D. Distribution of inflammatory infiltrate in the lung
E. Kind of chemical mediators initiating injury
Answer
